Which disorder is defined as repeated passage of feces into inappropriate places, occurring at least once per month for three months, and requiring the child to be at least four years old?

• A. Enuresis
• B. Encopresis
• C. Insomnia Disorder
• D. Hypersomnolence

Answer: (B)

This item tests elimination disorders, specifically encopresis. Encopresis is the repeated passage of feces into inappropriate places, occurring at least once a month for three months, in a child who is at least four years old. The age criterion ensures the behavior is developmentally inappropriate, and the monthly frequency for several months shows it is persistent rather than incidental. It must not be attributable to a medical condition or substance, though functional constipation with overflow incontinence is a common underlying mechanism and can contribute to the problem. This disorder is about defecation patterns, not urination or sleep, which is why it isn’t about enuresis or sleep disorders like insomnia or hypersomnolence. Encopresis best fits the criteria because it aligns exactly with the developmental age, frequency, and duration requirements.